[Federal Register Volume 86, Number 51 (Thursday, March 18, 2021)]
[Rules and Regulations]
[Pages 14690-14693]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2021-05548]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
42 CFR Parts 400, 410, 414, 415, 423, 424, and 425
[CMS-1734-F, CMS-1734-IFC, CMS-1744-F, CMS-5531-F and CMS-3401-IFC] CN
RIN 0938-AU10, 0938-AU31, 0938-AU32, and 0938-AU33
Medicare Program; CY 2021 Payment Policies Under the Physician
Fee Schedule and Other Changes to Part B Payment Policies; Medicare
Shared Savings Program Requirements; Medicaid Promoting
Interoperability Program Requirements for Eligible Professionals;
Quality Payment Program; Coverage of Opioid Use Disorder Services
Furnished by Opioid Treatment Programs; Medicare Enrollment of Opioid
Treatment Programs; Electronic Prescribing for Controlled Substances
for a Covered Part D Drug; Payment for Office/Outpatient Evaluation and
Management Services; Hospital IQR Program; Establish New Code
Categories; Medicare Diabetes Prevention Program (MDPP) Expanded Model
Emergency Policy; Coding and Payment for Virtual Check-In Services
Interim Final Rule Policy; Coding and Payment for Personal Protective
Equipment (PPE) Interim Final Rule Policy; Regulatory Revisions in
Response to the Public Health Emergency (PHE) for COVID-19; and
Finalization of Certain Provisions From the March 31st, May 8th and
September 2nd Interim Final Rules in Response to the PHE for COVID-19;
Correction
AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.
ACTION: Final rule and interim final rule; correction.
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SUMMARY: This document corrects technical errors in the final rule that
appeared in the December 28, 2020, Federal Register entitled,
``Medicare Program; CY 2021 Payment Policies under the Physician Fee
Schedule and Other Changes to Part B Payment Policies; Medicare Shared
Savings Program Requirements; Medicaid Promoting Interoperability
Program Requirements for Eligible Professionals; Quality Payment
Program; Coverage of Opioid Use Disorder Services Furnished by Opioid
Treatment Programs; Medicare Enrollment of Opioid Treatment Programs;
Electronic
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Prescribing for Controlled Substances for a Covered Part D Drug;
Payment for Office/Outpatient Evaluation and Management Services;
Hospital IQR Program; Establish New Code Categories; Medicare Diabetes
Prevention Program (MDPP) Expanded Model Emergency Policy; Coding and
Payment for Virtual Check-in Services Interim Final Rule Policy; Coding
and Payment for Personal Protective Equipment (PPE) Interim Final Rule
Policy; Regulatory Revisions in Response to the Public Health Emergency
(PHE) for COVID-19; and Finalization of Certain Provisions from the
March 31st, May 8th and September 2nd Interim Final Rules in Response
to the PHE for COVID-19'' (hereinafter referred to as the CY 2021 PFS
final rule).
DATES: This correction is effective March 18, 2021, and is applicable
beginning January 1, 2021.
FOR FURTHER INFORMATION CONTACT: Terri Plumb, (410) 786-4481, Gaysha
Brooks, (410) 786-9649, or Annette Brewer (410) 786-6580.
SUPPLEMENTARY INFORMATION:
I. Background
In FR Doc. 2020-26815 of December 28, 2020, the CY 2021 PFS final
rule (85 FR 84472), there were technical errors that are identified and
corrected in this correcting document. These corrections are effective
and applicable beginning January 1, 2021.
II. Summary of Errors
A. Summary of Errors in the Preamble
On page 84503, in the Medicare telehealth services list, due to a
typographical error, the CPT code is incorrect.
On page 84513 in Table 14: Final Services for Temporary Addition to
the Medicare Telehealth Services List, we inadvertently included CPT
code 96121.
On page 84516 in Table 14: Final Services for Temporary Addition to
the Medicare Telehealth Services List, we inadvertently included CPT
codes 99221, 99222, and 99223.
On page 84560 in Table 23: CY 2020 Work RVUs and CY 2021 Final Work
RVUs, we inadvertently included CPT codes 99492 and 99493 and
inadvertently omitted HCPCS codes G2211 and G2212. There were no
changes made to the work RVUs for CPT codes 99492 and 99493 in this
final rule.
On page 84562 in Table 24: Comparison of Physician Time, and
Clinical Staff Time (Non-facility and Facility) for HCPCS Codes, CY
2020 Values vs. 2021 Final Values, we inadvertently included CPT codes
99492 and 99493 and inadvertently omitted HCPCS Codes G2211 and G2212.
On page 84665 in Table 28: CY 2021 Work RVUs for New, Revised and
Potentially Misvalued Codes, due to a typographical error, we
inadvertently included the incorrect descriptor for HCPCS code G2216.
B. Summary and Correction of Errors in the Addenda on the CMS Website
Due to a technical change that was applied in error to the indirect
practice expense (PE) allocation for HCPCS codes G2082 and G2083 in the
final rule, the Addendum B posted on the CMS website contained errors
for the Non-Facility PE RVUs, Facility PE RVUs, Total Non-Facility
RVUs, and the Total Facility RVUs. Specifically, we assigned an
incorrect physician specialty in our ratesetting process to the
predecessor codes for HCPCS codes G2082 and G2083 in the CY 2020 PFS
final rule and CY 2021 PFS proposed rule. We intended to correct the
assigned physician specialty for these codes in the CY 2021 PFS final
rule; however, we neglected to discuss this correction in the course of
PFS rulemaking for CY 2021. Since this technical change was applied in
the CY 2021 PFS final rule, but was not discussed in the course of PFS
rulemaking for CY 2021, we are removing this change for the 2021
calendar year, retroactive to January 1, 2021. The Non-Facility PE
RVUs, Facility PE RVUs, Total Non-Facility RVUs, and Total Facility
RVUs that resulted from the correction of this error are reflected in
the revised CY 2021 Addendum B available on the CMS website at https://www.cms.gov/medicaremedicare-fee-service-paymentphysicianfeeschedpfs-federal-regulation-notices/cms-1734-f. Specifically, we are correcting
the following:
1. In Addendum B--Relative Value Units and Related Information Used
in the CY 2021 PFS final rule, line 12615 for CPT/HCPCS code G2082,
Visit esketamine 56m or less,
a. Seventh column, the Non-Facility PE RVUs the value ``17.68'' is
corrected to read ``24.06''.
b. Eighth column, the Facility PE RVUs the value '' 0.17'' is
corrected to read ``0.27''.
c. Tenth column, Total Non-Facility RVUs the value ``18.43'' is
corrected to read ``24.81''.
d. Eleventh column, Total Facility RVUs the value ``0.92'' is
corrected to read ``1.02''.
2. In Addendum B--Relative Value Units and Related Information Used
in the CY 2021 PFS final rule, line 12616 for CPT/HCPCS G2083 for Visit
esketamine, >56m,
a. Seventh column the Non-Facility PE RVUs the value ``25.54'' is
corrected to read ``34.72''.
b. Eighth column the Facility PE RVUs the value ``0.17'' is
corrected to read ``0.27''.
c. Tenth column, Total Non-Facility RVUs the value ``26.29'' is
corrected to read ``35.47''.
d. Eleventh column Total Facility RVUs the value ``0.92'' is
corrected to read ``1.02''.
III. Waiver of Proposed Rulemaking and Delay in Effective Date
Under 5 U.S.C. 553(b) of the Administrative Procedure Act (the
APA), the agency is required to publish a notice of the proposed rule
in the Federal Register before the provisions of a rule take effect.
Similarly, section 1871(b)(1) of the Social Security Act (the Act)
requires the Secretary to provide for notice of the proposed rule in
the Federal Register and provide a period of not less than 60 days for
public comment. In addition, section 553(d) of the APA and section
1871(e)(1)(B)(i) of the Act mandate a 30-day delay in effective date
after issuance or publication of a rule. Sections 553(b)(B) and
553(d)(3) of the APA provide for exceptions from the APA notice and
comment, and delay in effective date requirements; in cases in which
these exceptions apply, sections 1871(b)(2)(C) and 1871(e)(1)(B)(ii) of
the Act provide exceptions from the notice and 60-day comment period
and delay in effective date requirements of the Act as well. Section
553(b)(B) of the APA and section 1871(b)(2)(C) of the Act authorize an
agency to dispense with normal notice and comment rulemaking procedures
for good cause if the agency makes a finding that the notice and
comment process is impracticable, unnecessary, or contrary to the
public interest, and includes a statement of the finding and the
reasons for it in the rule. In addition, section 553(d)(3) of the APA
and section 1871(e)(1)(B)(ii) allow the agency to avoid the 30-day
delay in effective date where such delay is contrary to the public
interest and the agency includes in the rule a statement of the finding
and the reasons for it.
In our view, this correcting document does not constitute a
rulemaking that would be subject to these requirements. This document
merely corrects technical errors in the CY 2021 PFS final rule. The
corrections contained in this document are consistent with, and
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do not make substantive changes to, the policies and payment
methodologies that were proposed, subject to notice and comment
procedures, and adopted in the CY 2021 PFS final rule. As a result, the
corrections made through this correcting document are intended to
resolve inadvertent errors so that the CY 2021 PFS final rule
accurately reflects the policies adopted in the final rule. Even if
this were a rulemaking to which the notice and comment and delayed
effective date requirements applied, we find that there is good cause
to waive such requirements. Undertaking further notice and comment
procedures to incorporate the corrections in this document into the CY
2021 PFS final rule or delaying the effective date of the corrections
would be contrary to the public interest because it is in the public
interest to ensure that the rule accurately reflects our policies as of
the date they take effect. Further, such procedures would be
unnecessary because we are not making any substantive revisions to the
final rule, but rather, we are simply correcting the Federal Register
document to reflect the policies that we previously proposed, received
public comment on, and subsequently finalized in the CY 2021 PFS final
rule. For these reasons, we believe there is good cause to waive the
requirements for notice and comment and delay in effective date.
IV. Correction of Errors
In FR Doc. 2020-26815 (85 FR 84472), published December 28, 2020,
make the following corrections:
A. Correction of Errors in the Preamble
1. On page 84503, second column, third bullet, third line, the
number ``994780'' is corrected to read ``99478''.
2. On page 84513 in Table 14: Final Services for Temporary Addition
to the Medicare Telehealth Services List, the second column, the third
row, is corrected by removing the listing for HCPCS code 96121 in the
second and third columns.
3. On page 84516 in Table 14: Final Services for Temporary Addition
to the Medicare Telehealth Services List, the second column, the
second, third, and fourth rows are corrected by removing the listings
for HCPCS codes 99221, 99222, and 99223 in the second and third
columns.
4. On page 84560, Table 23: CY 2020 Work RVUs and CY 2021 Final
Work RVUs, is corrected by removing CPT codes 99492 and 99493 and
adding rows for HCPCS codes G2211 and G2212 to read as follows:
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CY 2020 work Final CY 2021
HCPCS code Long descriptor RVUs work RVUs
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G2211.................................. Visit complexity inherent to evaluation N/A 0.33
and management associated with medical
care services that serve as the
continuing focal point for all needed
health care services and/or with
medical care services that are part of
ongoing care related to a patient's
single, serious condition or a complex
condition. (Add-on code, list
separately in addition to office/
outpatient evaluation and management
visit, new or established).
G2212.................................. Prolonged office or other outpatient N/A 0.61
evaluation and management service(s)
beyond the maximum required time of
the primary procedure which has been
selected using total time on the date
of the primary service; each
additional 15 minutes by the physician
or qualified healthcare professional,
with or without direct patient contact
(List separately in addition to CPT
codes 99205, 99215 for office or other
outpatient evaluation and management
services). (Do not report G2212 on the
same date of service as 99354, 99355,
99358, 99359, 99415, 99416). (Do not
report G2212 for any time unit less
than 15 minutes).
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5. On page 84562, Table 24: Comparison of Physician Time, and
Clinical Staff Time (Non-facility and Facility) for HCPCS Codes, CY
2020 Values vs. 2021 Final Values, is corrected by removing CPT codes
99492 and 99493 and adding rows for HCPCS codes G2211 and G2212 to read
as follows:
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NF clinical NF clinical Fac. clinical Fac. clinical
Phys. time Phys. time staff time staff time staff time staff time
HCPCS (minutes)-- CY (minutes)-- CY (minutes)-- CY (minutes)-- CY (minutes)-- CY (minutes)-- CY
2020 2021 final 2020 2021 final 2020 2021 final
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G2211................................................... 11 11 0 0 0 0
G2212................................................... 15 15 2 2 0 0
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6. On page 84665 in Table 28: CY 2021 Work RVUs for New, Revised
and Potentially Misvalued Codes, the second column, the third row, the
phrase ``Take-home supply of auto-injector naloxone'' is corrected to
read ``Take-home supply of injectable naloxone''.
Dated: March 12, 2021.
Wilma M. Robinson,
Deputy Executive Secretary to the Department, Department of Health and
Human Services.
[FR Doc. 2021-05548 Filed 3-16-21; 8:45 am]
BILLING CODE 4120-01-P